Key result
Diabetes mellitus (OR 1.47; 95% CI 1.19-1.83), smoking, family history of CAD, and complex lesion characteristics were significant predictors of in-stent restenosis following DES implantation.
Why the study?
Numerous studies have investigated in-stent restenosis predictors in first-generation drug-eluting stents, but only a few have evaluated second-generation devices.
What are the clinical and angiographic predictors of in-stent restenosis following drug-eluting stent implantation in patients with coronary artery disease?
Meta-Analysis
What are the clinical and angiographic predictors of in-stent restenosis following drug-eluting stent implantation in patients with coronary artery disease?
Odds Ratio: 1.47 (95% CI 1.19–1.83)
p-value: p=<0.01
Diabetes, smoking, family history of CAD, multi-vessel disease, complex lesions, smaller stent diameter, and longer stent length are significant predictors of in-stent restenosis after DES implantation.
Diabetes, smaller diameter, and longer stents identify higher DES-ISR risk; confirms predictors to guide selection and future trials.
Numerous studies have investigated in-stent restenosis (ISR) predictors in first-generation drug-eluting stents (DESs), but only a few have investigated second-generation DESs. We aimed to investigate the ISR predictors following a successful DES implantation in coronary artery disease (CAD) patients. A systematic review and meta-analysis study was conducted. Diabetes mellitus (DM) (OR 1.47; 95% CI 1.19 to 1.83; p < 0.01), family history of CAD (OR 1.26; 95% CI 1.03 to 1.55; p 0.03), and smoking (OR 1.23; 95% CI 1.02 to 1.48; p 0.03) were the strong predictors for the DES-ISR. The DES-ISR was more common in DESs with smaller stent diameter (MD −0.12; 95% CI −0.16 to −0.08; p < 0.01) and longer stent length (MD 2.24; 95% CI 1.36 to 3.13; p < 0.01). Angiography characteristics, including multi-vessel disease (MVD) (OR 1.45; 95% CI 1.07 to 1.97; p 0.02), type B2/C lesions (OR 1.56; 95% CI 1.06 to 2.30; p 0.02), and type C lesion (OR 1.33; 95% CI 1.09 to 1.62; p < 0.01), were also associated with DES-ISR. We confirmed that DM, family history of CAD, smoking, MVD, smaller stent diameter, longer stent length, and type B2 or C lesions were proven to be ISR predictors following DES implantation.
No takes yet. Share an insight, caveat, or question.
Rohman et al. (2023) conducted a meta-analysis in Coronary artery disease (CAD). Diabetes mellitus, smoking, family history of CAD, and complex lesion characteristics vs. Absence of these risk factors was evaluated on In-stent restenosis (ISR) (OR 1.47, 95% CI 1.19 to 1.83, p=<0.01). Diabetes mellitus (OR 1.47; 95% CI 1.19-1.83), smoking, family history of CAD, and complex lesion characteristics were significant predictors of in-stent restenosis following DES implantation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: